Telemedicine in assisted reproduction

The use of information and communication technology (ICT) has become so commonplace in our lives that we can now hardly imagine living without it. ICT penetrated the healthcare field more slowly than other areas, although this began decades ago, aim early applications was to reduce disparity access care between rural urban populations. Recent years have seen increasing interest development application telehealth. However, been uneven medical specialties and, some cases, within a given medicine. In case obstetrics gynaecology, studied family planning, gynaecologic oncology, high- low-risk obstetric patients (Greiner, 2017Greiner A.L. Telemedicine Applications Obstetrics Gynecology: Clin.Obstet. Gynecol. 2017; 60 (https://doi.org/): 853-866https://doi.org/10.1097/GRF.0000000000000328Crossref Scopus (24) Google Scholar; Rayburn, 2020Rayburn W.F. Role Improving Women's Health Care.Obstet. Clin. North Am. 2020; 47 xiii-xxivhttps://doi.org/10.1016/j.ogc.2020.03.002Abstract Full Text PDF PubMed (1) Triberti et al., 2019Triberti S. Savioni L. Sebri V. Pravettoni G. eHealth for improving quality life breast cancer patients: A systematic review.Cancer Treat. Rev. 2019; 74 1-14https://doi.org/10.1016/j.ctrv.2019.01.003Abstract (38) Scholar), management abortion (Endler 2019Endler M. Lavelanet A. Cleeve Ganatra B. Gomperts R. Gemzell-Danielsson K. abortion: review.BJOG Int. J. Obstet. Gynaecol. 126 1094-1102https://doi.org/10.1111/1471-0528.15684Crossref (59) recently reproductive medicine (Hernández 2020Hernández C. Valdera C.J. Cordero López E. Plaza Albi Impact telemedicine on assisted reproduction treatment public health system.J. Healthc. Qual. Res. 35 27-34https://doi.org/10.1016/j.jhqr.2019.08.004Crossref (13) Scholar). Telehealth is broad term used refer deliver health-related services. Telemedicine, one components telehealth focuses rendering clinical services (Scott Mars, 2016Scott R.E. Mars Same Language Speak We Do - Consensus Terminology Telehealth.Stud. Technol. Inform. 2016; 231: 99-109PubMed grown at slow pace, especially such as gynaecology; however, pandemic caused by coronavirus disease 2019 (COVID-19) prompted systems develop or strengthen existing ones across all order comply with social distancing initiatives. good example us Schulz 2020Schulz T. Long Kanhutu Bayrak I. Johnson D. Fazio during pandemic: Rapid expansion outpatient possible if programme previously established.J. Telemed. Telecare. (1357633X2094204. https://doi.org/)https://doi.org/10.1177/1357633X20942045Crossref (9) Scholar, who recent article describing experience tertiary hospital Melbourne, Australia, reported 2255% increase February April 2020, bringing proportion type consultation from 1% 28% total appointments facility (Schulz Such high level unlikely continue after pandemic, rate will probably not return pre-COVID-19 levels. believe exceptional situation should drive create programs, improve initiatives, reproduction; these efforts be undertaken an awareness advantages drawbacks telemedicine, well limitations barriers must overcome are delivering safe, care. current situation, enables leverage available provide remote care, making it plausible maintain while considerably reducing number visits, thereby lowering risk infection. Another advantage fertility added efficiency ability limited resources. Expanding population primary concern health, greater come expense provided. When instituting system, providers clear idea delivered. Numerous studies published regarding video consultations synchronous form which physicians interact real time. Other asynchronous means providing also exist, electronic patient portal (EPP), text messaging, e-mail. choice system over another depends multiple factors technological both provider patient, conditions imposed private reimbursement, demographic characteristics target population, transmitted via Combining methods attractive alternative allows two modalities complement each other, thus leading improved There many opportunities reproduction, may even deployed before first consultation. bulk comes EPP any device, including computers, tablets, smartphones. Patients learn how prepare initial visit e-visit, uses completed questionnaire basic study; way, appointment time spent evaluating results study alongside patient's record opportunity related follow-up visits give complementary tests; in-person substituted consultations, telephone reports uploaded directly provided relayed appropriate complexity. Regardless used, adhere legal requirements state country where using EPP, advisable forms complete prior assessment ensure aims remains updated. It highly useful channel web dialog, ask questions receive response shortest possible; tools continuity process decrease treatment-related stress. With regard ovarian stimulation, Gerris 2014Gerris Delvigne Dhont N. Vandekerckhove F. Madoc Buyle Neyskens Deschepper De Bacquer Pil Annemans Verpoest W. Sutter P. Self-operated endovaginal telemonitoring versus traditional monitoring stimulation reproduction: RCT.Hum. Reprod. 2014; 29 1941-1948https://doi.org/10.1093/humrep/deu168Crossref (15) Scholar found self-operated (SOET) less effective laboratory test increased satisfaction among their partners, sense empowerment, stress, cost-savings (Gerris 2-D ultrasonographic images obtained either partners sent specialists. Currently, software programs SonoAVC (automated volume calculation) enable automatic determination follicular size; there no evidence suggesting performs better measurement (Wertheimer 2018Wertheimer Nagar Oron Meizner Fisch Ben-Haroush Fertility Treatment Outcomes After Follicle Tracking Standard 2-Dimensional Sonography Versus 3-Dimensional Sonography-Based Automated Volume Count: Prospective Study.J. Ultrasound Med. Off. Inst. 2018; 37 859-866https://doi.org/10.1002/jum.14421Crossref (5) post-processing aid required evaluation. main limitation availability sufficient devices perform monitoring, particularly fact occasions several beginning important aspect process, great impact emotional well-being patients, when inform results. Stewart 2001Stewart Hamilton McTavish Fitzmaurice Graham Randomized controlled trial comparing couple unsuccessful IVF/ICSI treatment.Hum. Fertil. 2001; 4 249-255https://doi.org/10.1080/1464727012000199611Crossref (8) compared treatment, finding significant difference survey, 91% couples received questionnaire. Significant differences were length consultation, shorter (Stewart Although include conferencing agreed upon explained them depth initiation acceptance satisfaction. As here, certain situations telehealth, specifically benefits. indicated previously, technologies benefits limitations; instance, regulations applicable introducing program entirely clear, countries regulatory framework whatsoever this. lack explicit matter, carried out under aegis laws intended purpose, creating vacuums pose burden delay rollout activity due concerns implications. While throughout settings city New York, nearly 50% low-income households internet (Bakhtiar 2020Bakhtiar Elbuluk Lipoff J.B. digital divide: Covid-19’s could exacerbate disparities.J. Acad. Dermatol. (https://doi.org/)https://doi.org/10.1016/j.jaad.2020.07.043Abstract (20) This services; connectivity smartphones, devices, disparities rather remedy (Gogia 2016Gogia S.B. Maeder Hartvigsen Basu Abbott Unintended Consequences Tele Possible Solutions: Contribution IMIA Working Group Telehealth.Yearb. 25 41-46https://doi.org/10.15265/IY-2016-012Crossref impacts introduced setting. true enterprises facilities mostly easy establish program, evolved rapidly years, hold send high-resolution much quickly securely 10 ago; initiatives strong support professionals workflow agile, real-time decision problems do arise. One disadvantage loss misinterpretation data. Systems text-based, SMS email, prone errors poor spelling, autocorrect function missing information; therefore, textual data continuously reviewed, slows process. Erroneous entered misinterpreted body movements technical difficulties individual too far close microphone, device's camera focus, lighting dehumanization ITC workers, though highlighted bring about improvement empowerment properly planned delivered context based relationship trust, support, taking into account needs (Rubeis 2018Rubeis Schochow Steger Patient Autonomy Quality Care Telehealthcare.Sci. Eng. Ethics. 24 93-107https://doi.org/10.1007/s11948-017-9885-3Crossref obstacles hamper institute language barrier resistance change. former substantial challenge available; isolated problem individualized identify potential challenges offer solutions. Resistance change, hand, complex phenomenon, staff training newly implemented employee motivation ease transition. doubt here stay practice, coming likely advances realm. emerging enter telemedicine. For example, artificial intelligence machine learning currently being evaluated different fields medicine, embryo gamete selection (Wang 2019Wang Pan Jin Li Y. Geng Gao Chen Wang H. Ma Liao Artificial medicine.Reprod. Camb. Engl. 158 R139-R154https://doi.org/10.1530/REP-18-0523Crossref (18) Algorithms outside IVF decision-making (Letterie Mac Donald, 2020Letterie Donald vitro fertilization: computer day-to-day fertilization.Fertil. Steril. 114 1026-1031https://doi.org/10.1016/j.fertnstert.2020.06.006Abstract (6) Scholar) predict outcome (Bori 2020Bori Paya Alegre Viloria T.A. Remohi J.A. Naranjo Meseguer Novel conventional parameters input neural networks: model applied prediction implantation potential.Fertil. (https://doi.org/)https://doi.org/10.1016/j.fertnstert.2020.08.023Abstract (4) – sophisticated algorithms deep still stages, motivating think immediate answers requests according characteristics, personal preferences, help advising additional necessary indicating avoiding unnecessary consultations. interesting advance biological time, diabetes resulted revolution condition (Warren 2018Warren Carlisle Mihala Scuffham P.A. Effects glycaemic control costs 2 diabetes: randomised trial.J. 586-595https://doi.org/10.1177/1357633X17723943Crossref measures glucose tissues (interstitial) sensor flexible filament inserted skin; values through transmitter receiving device (monitor, smartphone, etc.). today interstitial sensors measure oestradiol, progesterone HCG, hormones saliva (Schiffer 2019Schiffer Adaway J.E. Baranowski E.S. Arlt Keevil B.G. novel high-throughput assay salivary liquid chromatography tandem mass spectrometry.Ann. Biochem. 56 64-71https://doi.org/10.1177/0004563218780904Crossref Perhaps near future able undergo hormonal tranquillity home wherever they gynaecologist need doctor travel. outweigh drawbacks, most disadvantages absence specific framework, insufficient mobile require Technological introduction functionality faster part continues penetrate sector, expect accept readily; additionally, easier embrace new endometrium preparation cycles cryopreserved embryos. Together, changes only efficiency, but make onerous cost-efficient replace hospital, resulting fewer hours missed work reduced associated travel accommodation. Nonetheless, agree International Medical Informatics Association (IMIA) argue its modalities, nothing well-defined lose sight aim, good-quality personalized helps achieve goals.